The evolution of computed tomography (CT) from four to 16 to 64 sections since its inception in the late 1970s has led to more widespread use of this imaging modality in the emergent setting. CT angiography has become a crucial diagnostic technique for identifying vascular injury in the trauma patient. ...

INTRODUCTION: We developed a new shockroom resuscitation setting that includes a moveable, multislice computed tomography (CT) scanner capable of scanning patients during the initial trauma resuscitation phase without (multiple) patient transfers that previously were necessary. This enables us to perform a complete diagnostic trauma workup, without leaving the shockroom. In ...

Many trauma patients undergo advanced diagnostic imaging before being transferred to a regional trauma centre, but this step can delay definitive care. This study compared the length-of-stay at the primary hospital between patients who underwent CT scans and those who did not. This was a medical record review of all ...

Injuries to the cervical spine (CS) occur in 2% to 6.6% of blunt trauma patients. Studies have suggested that computed tomography (CT) alone is sufficient for CS clearance in unreliable patients based on follow-up magnetic resonance (MR) imaging not altering management. We hypothesized that an admission cervical spine CT with ...

This study developed and validated finite element (FE) models of swine and human thoraxes and abdomens that had subject-specific anatomies and could accurately and efficiently predict body responses to blunt impacts. Anatomies of the rib cage, torso walls, thoracic, and abdominal organs were reconstructed from X-ray computed tomography (CT) images ...

This article provides an overview of two relatively new techniques that can be used for the early detection of musculoskeletal injury: biochemical markers and CT. The emphasis in the biomarker section is on the early detection of joint disorders because these are most important clinically and most of the research ...

Foot and ankle injuries are among the most common of all sports-related injuries. Many injuries are simplistic from a diagnostic standpoint, whereas others require a high level of suspicion and the use of appropriate diagnostic imaging modalities. Whether a professional athlete or a weekend warrior, all athletes want minimal disruption ...

BACKGROUND: The model of care for patients with mild-to-moderate head injury and CT-detected lesions that do not require an immediate intervention is a matter of debate. This study compared the effects on outcome of a model based either on observation in a neurosurgical unit (NSU) or in a peripheral hospital ...

BACKGROUND: CT has evolved as the gold standard for evaluation of head injury, but early CT is not always possible. Bedside ultrasonography is available in most trauma units and optic nerve ultrasound (ONUS) examination should be feasible. OBJECTIVE: To evaluate the role of ONUS for people with head injury. SETTING: ...

BACKGROUND: A transorbital intracranial injury with a wooden foreign body can be very difficult to diagnose and manage. The orbit forms an easy path for low-velocity foreign bodies into the intracranial space. The severity of the injury is often masked by unobtrusive superficial wounds. Computed tomography (CT) findings may be ...

BACKGROUND: Traumatic subdural hygroma (TSHy) is an accumulation of cerebrospinal fluid (CSF) in the subdural space after head injury. It appears to be relatively common, but its onset time and natural history are not well defined. Considered a benign epiphenomenon of trauma, the pathogenesis of TSHy is still unclear and ...

Intracranial haemorrhage can be a devastating disorder that requires rapid diagnosis and management. Neuroimaging studies are not only required for diagnosis but also provide important insights into the type of haemorrhage, the underlying aetiology, and the accompanying pathophysiology. Historically, CT has been the diagnostic imaging study of choice; however, there ...

PURPOSE: To identify the etiology of inferior epigastric artery injury (IEAI) in patients referred to the interventional radiology service and determine the efficacy of diagnostic imaging and embolization in these patients. MATERIALS AND METHODS: A retrospective review of patients referred to the interventional radiology departments at three university-affiliated hospitals from ...

Pediatric vascular injuries are rare but can be difficult to diagnose and challenging to manage. We present our experience with computed tomographic angiography in 3 pediatric patients with vascular injuries secondary to blunt trauma. Computed tomographic angiography is noninvasive, fast, rapidly available in most centers, and can evaluate for other ...

The key structures involved in dislocation of the acromioclavicular joint (ACJ) are the joint itself and the strong accessory coracoclavicular ligament. ACJ dislocations are classified with the Rockwood system, which comprises six grades of injury. Treatment planning requires accurate grading of the ACJ disruption, but correct classification can be difficult ...

Pelvic avulsion injuries occur in both the skeletally immature and adult patient populations. Avulsion injuries are most common in the adolescent age group and usually present as an avulsion of the unfused apophysis at the level of tendon attachment resulting from violent muscular contraction during an athletic endeavor. Acute apophyseal ...

Global hypoxic-ischemic injury (HII) to the brain is a significant cause of mortality and severe neurologic disability. Imaging plays an important role in the diagnosis and treatment of HII, helping guide case management in the acute setting and providing valuable information about long-term prognosis. Appropriate radiologic diagnosis of HII requires ...

OBJECTIVE: This study aimed to report our experience with regard to imaging of mass casualty incidents (MCIs). SUBJECTS AND METHODS: Following a bomb attack, 150 casualties were referred to our hospital. Radiographs and nonenhanced CT scans were performed in 28 individuals. RESULTS: Major injuries were seen in 12 individuals, which ...

INTRODUCTION: Mild traumatic brain injury (MTBI) is a common neurotraumatologic diagnosis. It is possible to confirm objective cognitive impairment in MTBI patients not only by complex neuropsychological testing but also by event-related potentials (ERPs). The most common ERPs used in clinical practice are based on an oddball paradigm. Magnetic resonance ...

We report the case of a 16-year-old girl with a history of idiopathic precocious puberty and normal results on pituitary imaging scan. Ten years later, a new cranial magnetic resonance imaging scan was performed due to worsening of episodes resembling Horton's headache and a lesion suggestive of pituitary bleeding was ...

MR imaging provides soft tissue detail unparalleled by any other modality for the assessment of turf toe injuries and has become standard in certain populations of athletic patients. Principal knowledge of the anatomy and appropriate imaging techniques is central for accurate imaging evaluation. The precise determination of the structures involved ...

Traditionally, conventional arteriography is the diagnostic modality of choice to evaluate for arterial injury. Recent technological advances have resulted in multidetector, fine resolution computed tomographic angiography (CTA). This study examines CTA for evaluation of extremity vascular trauma compared with conventional arteriography. Our hypothesis is that CTA provides accurate and timely ...

This article illustrates the MDCT postmortem imaging features that have the potential to enhance forensic investigation and conventional autopsy. MDCT may guide, direct, or limit forensic autopsy in projectile injury cases, thereby eliminating the need for a complete invasive autopsy.

An 11-year-old girl presented with a swollen medial aspect of the left forefoot following a blunt injury. Initial imaging revealed a well-defined calcific structure with a radiolucent line across it, medial to the head of the first metatarsal. The swelling and pain completely subsided over the course of the following ...

In severe head injury brain midline shift in Computerized Tomography (CT) scan is a diagnostic sign. The aim of this study was to investigate prognostic value of brain shift by studying of correlation between brain shift and interpeduncular cisternal effacement with long term outcome, in patients with Glasgow Coma Scale ...

Transcutaneous ultrasound imaging may be used to detect abdominal hemorrhage in the field setting. The Focused Assessment with Sonography for Trauma (FAST) examination was developed to characterize blunt abdominal trauma and has been shown to be effective for assessing penetrating trauma as well. However, it is unlikely that a minimally ...

INTRODUCTION: While highly increased intracranial pressure (ICP) is of high predictive value indicating a fatal outcome, the predictive value of moderately increased ICP early after head injury remains uncertain. We compared the predictive value of ICP to the predictive value of magnetic resonance imaging (MRI) early after head injury. METHODS: ...

To evaluate the effectiveness of contrast-enhanced ultrasound (CEUS) in the diagnosis and characterization of hepatic, renal and splenic traumatic injuries versus conventional ultrasound (US) and multislice computed tomography (MS-CT). Between January 2005 and January 2007, 78 patients (48 males, 30 females, mean age 56 years) with blunt abdominal trauma were ...

BACKGROUND: Blunt ureteral and ureteropelvic (UPJ) injuries are extremely rare and very difficult to diagnose. Many of these injuries are missed by the initial trauma evaluation. METHODS: Trauma registry data was used to identify all blunt trauma patients with ureteral or UPJ injuries, from 1 April 2001 to 30 November ...

BACKGROUND: We studied musculoskeletal diseases (MSD) and injuries among fishermen and seamen with focus on low back disorders, carpal tunnel syndrome (CTS), rotator cuff syndrome and arthrosis. METHODS: Cohorts of all male Danish seamen (officers and non-officers) and fishermen employed 1994 and 1999 with at least six months employment history ...

Brain herniation from hemispheric mass lesions injures mainly the upper brainstem around the tentorial incisura. While mechanical tissue compression is usually the process of deterioration and injury, the primary injury mechanism in some patients is early brainstem ischemia from arterial compromise as demonstrated by this patient's magnetic resonance imaging (MRI) ...

Neonatal cerebral MR imaging is a sensitive technique for evaluating brain injury in the term and preterm infant. In term encephalopathic infants, MR imaging reliably detects not only the pattern of brain injury but might also provide clues about the timing of injury. In premature infants, MR imaging has surpassed ...

Hemophilic pseudotumor is an uncommon complication seen in approximately 1-2% of patients with severe hemophilia. Hemophilic pseudotumors are distinguished into two subdivisions based on location, proximal or distal. Plain x-rays and CT are useful in diagnosis, but MR imaging is the diagnostic test of choice because of its sensitivity to ...

BACKGROUND: There has been a progressive increase in the use of computerized tomography (CT) scans for evaluating trauma patients. The purpose of this study was to quantify that trend and consider the implications it holds for resource use. METHODS: Data were combined from the trauma registry and the radiology department's ...

BACKGROUND: Historically, thoracolumbar spine transverse process fractures (TVPFx) found on "plain films" of the spine were occasionally associated with occult, mechanically significant vertebral fractures. Thus, "log-roll precautions" have been used pending formal spine evaluation and further imaging. As integrated helical computed tomography (CT) scans of the torso have become routine ...

One third of women who experience intimate partner violence (IPV) receive some form of injury. After acute injuries have healed, a victim's physical appearance may be altered with residual changes including marks or scars. This study included 56 female victims of IPV (31 with appearance-related residual injury and a comparison ...

This three part series of articles has discussed mechanisms of electrode related injuries from a theoretical viewpoint in Part 1 (Stecker et al. 2006) and from a clinical experience viewpoint in Part 2 (Patterson et al. 2007). The third and final part of the series discusses practical concepts for the ...

PURPOSE: The aims of this study were to determine the value of chest radiography in diagnosing lung parenchymal injury in patients with thoracic trauma, and to evaluate the frequency of lung parenchymal injury by using thoracic computed tomography (CT). MATERIALS AND METHODS: Between January 2005 and June 2006, we retrospectively ...

BACKGROUND: Abusive head trauma (AHT) in young children usually has a severe outcome when associated with hypoxic-ischemic encephalopathy (HIE), which is best characterized by MRI in the acute or subacute phase utilizing diffusion-weighted imaging (DWI). HIE in this setting has been hypothesized to result from stretching of the spinal cord, ...

Patterns of injury to the levator ani in parous women with laparoscopy-negative, chronic pelvic pain (CPP) are described. A consecutive series of 26 parous women with laparoscopy-negative CPP, had magnetic resonance imaging (MRI) in axial, coronal and sagittal planes. Similar imaging studies were performed in 32 parous women having MRI ...

OBJECTIVE: To investigate clinical and imaging differential diagnosis and tennis stroke biomechanics potentially involved in lunate stress injury pathogenesis. METHODS: The present report describes five competitive tennis players with overuse-related dorsal wrist pain assessed by magnetic resonance imaging. RESULTS: Magnetic resonance imaging revealed the presence of lunate stress injury. All ...

Scapulothoracic dissociation is defined as violent lateral or rotational displacement of the shoulder girdle from its thoracic attachments with severe neurovascular injury. We describe the radiographic and associated magnetic resonance (MR) imaging findings of a case of scapulothoracic dissociation with brachial plexus injury in a 17-year-old man, and include a ...

The purpose of this article is to review both the pathophysiology and the computed tomography features of the hypoperfusion complex and shock viscera. The main findings include dilated fluid-filled loops of bowel with hyperenhancing mucosa, intensely enhancing kidneys and mesenteric vasculature, and small caliber, dense aorta and collapsed, slit-like inferior ...

INTRODUCTION: Cognitive complaints, such as poor concentration and memory deficits, are frequent after whiplash injury and play an important role in disability. The origin of these complaints is discussed controversially. Some authors postulate brain lesions as a consequence of whiplash injuries. Potential diffuse axonal injury (DAI) with subsequent atrophy of ...

Fat embolism syndrome (FES) is an uncommon but serious complication of traumatic injury and is frequently diagnostically challenging. In this paper, the authors present four patients who sustained lower extremity long bone injury and who had a normal Glasgow Coma Scale before orthopedic surgical intervention. However, postoperatively, significant neurological deterioration ...

PURPOSE: To prospectively and externally validate published national and international guidelines for the indications of computed tomography (CT) in patients with a minor head injury. MATERIALS AND METHODS: The study protocol was institutional review board approved. All patients implicitly consented to use of their deidentified data for research purposes. Between ...

A thorough medical inquiry is included in every aviation mishap investigation. While the gold standard of this investigation is a forensic pathology examination, numerous reports stress the important role of computed tomography in the postmortem evaluation of trauma victims. To characterize the findings identified by postmortem CT and compare its ...

The purposes of this article are to illustrate the variable CT and MRI features of carbon monoxide-induced brain injury and to discuss the underlying pathogenesis. Carbon monoxide can produce different patterns of brain injury in the acute and delayed stages. CT and MRI are valuable in the delineation of disease ...

The objectives of the study were to review the clinical entities that can cause ankylosis of the spine and to illustrate the spectrum of traumatic injury patterns. Ankylosing spondylitis, diffuse idiopathic systemic hyperostosis, degenerative spondyloarthropathy, and spinal canal stenosis can render the spine susceptible to trivial trauma. Multidetector computed tomography ...

We present the case of a patient who sustained blunt liver trauma after a motor vehicle crash that was subsequently complicated by the development of a large biloma. Early use of computed tomography (CT) scan and HIDA (hepatobiliary iminodiacetic acid) imaging enabled the prompt identification and management of the problem.